Novosti
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This journal is indexed in Scopus |
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Year 2014 Vol. 22 No 3
GENERAL AND SPECIAL SURGERY
V.G. BOGDAN, D.A. TOLSTOV
PROSPECTIVE RANDOMIZED CLINICAL TRIALS OF EFFICIENCY OF AUTOLOGOUS PLATELET-DERIVED CONCENTRATES TO STIMULATE REGENERATION OF TROPHIC ULCERS OF VENOUS ETIOLOGY
EE “Belarusian State Medical University”
The Republic of Belarus
Objectives. To analyze the clinical and social efficiency of the designed method of autologous platelet concentrates (APC) application in the complex treatment of patients with small-sized trophic venous ulcers.
Methods. Short- and long-term treatment results of 58 patients with chronic trophic ulcers of venous etiology have been evaluated. After pathogenetic surgical correction aimed to eliminate the causes of ulcers patients were divided into 2 groups depending on the method of treatment. In the main group to stimulate additionally the repairing of trophic ulcer a combined method of APC use (platelet-rich fibrin matrix (OTFM) and platelet-rich plasma (PRP) have been used. The main complex treatment has been performed in the comparison group. The clinical effectiveness of different treatment option was evaluated by means of the dynamics of changes of the ulcer area, epithelization rate, time of complete ulcer epithelization, duration of hospitalization. Social effect was estimated based on the analysis of life quality according to CIVIQ questionnaire.
Results. The additional use of APC in the complex treatment of patients with trophic venous ulcers was found out to lead to the increased rate of epithelization up to 0,09 (0,04; 0,2) cm2 per day, significant reduction of ulcerous defect in dynamics (p<0,05), decline of complete ulcer healing occurrence (p<0,05) on the 10th day, increase of life quality according to questionnaire CIVIQ on 12,5 points (p<0,05).
Conclusions. The developed method of treating patients with trophic venous ulcers based on a stimulating effect of autologous platelet concentrates is considered to improve the efficiency of complex treatment and achieve a significant social effect in the postoperative period.
- Shevchenko IuL, Stoiko IuM, Lytkina MI, red. Osnovy klinicheskoi flebologii [Fundamentals of clinical phlebology]. Moscow, RF: OAO Meditsina. 2005. p. 246.
- Obolenskii VN. Khronicheskaia rana: obzor sovremennykh metodov lecheniia [Chronic wound: a review of current methods of treatment]. Rus Med Zhurn. 2013;21(5):282–89.
- Enoch S, Harding K. Wound bed preparation: The science behind the removal of barriers to healing. Wounds. 2003;15(7):213–29.
- Trent JT, Falabella A, Eaglstein WH, Kirsner RS. Ostomy Wound Manage. Venous ulcers: pathophysiology and treatment options. 2005 May;51(5):38-54; quiz 55–56.
- Mendez MV, Stanley A, Phillips T, Murphy M, Menzoian JO, Park HY. Fibroblasts cultured from distal lower extremities in patients with venous reflux display cellular characteristics of senescence. J Vasc Surg. 1998 Dec;28(6):1040–50.
- Mendez MV, Stanley A, Park HY, Shon K, Phillips T, Menzoian JO. Fibroblasts cultured from venous ulcers display cellular characteristics of senescence. J Vasc Surg. 1998 Nov;28(5):876–83.
- Bogdan VG, Tolstov DA, Bagatka SS, Zafranskaia MM. Biologicheskie effekty trombotsitarnykh kontsentratov v kul'ture fibroblastov kozhi cheloveka [Biological effects of platelet concentrates in the culture of human skin fibroblasts]. Med Zhurn. 2012;(2):22–25.
- Stanley AC, Park HY, Phillips TJ, Russakovsky V, Menzoian JO. Reduced growth of dermal fibroblasts from chronic venous ulcers can be stimulated with growth factors. J Vasc Surg. 1997 Dec;26(6):994–99.
- Prakash S, Thakur A. Platelet concentrates: past, present and future. J Maxillofac Oral Surg. 2011 Mar;10(1):45–49.
- Zorin VL, Zorina AI, Petrakova OS, Cherkasov VR. Dermal'nye fibroblasty dlia lecheniia defektov kozhi [Dermal fibroblasts to treat skin defects]. Klet Transplantologiia i Tkan Inzheneriia. 2009;4(4):26-40.
- Marx RE. Platelet-rich plasma (PRP): what is PRP and what is not PRP? Implant Dent. 2001;10(4):225–28.
- Dohan Ehrenfest DM, Rasmusson L, Albrektsson T. Classification of platelet concentrates: from pure platelet-rich plasma (P-PRP) to leucocyte- and platelet-rich fibrin (L-PRF). Trends Biotechnol. 2009 Mar;27(3):158–67.
- Savchenko IuP, Fedosov SR. Metody opredeleniia razmerov ranevoi poverkhnosti [Methods for determining of the wound surface size]. Vestn Khirurgii im II Grekova. 2007;166(1):102–105.
- Abaev IuK. Spravochnik khirurga. Rany i ranevaia infektsiia [A handbook of surgeon. Wounds and wound infection]. Rostov n/D: Feniks; 2006. 427 p.
- Launois R1, Reboul-Marty J, Henry B. Construction and validation of a quality of life questionnaire in chronic lower limb venous insufficiency (CIVIQ). Qual Life Res. 1996 Dec;5(6):539–54.
220034, Respublika Belarus, g. Minsk, ul. Azgura, d.4, Voenno-meditsinskiy fakultet v UO «Belorusskiy gosudarstvennyiy meditsinskiy universitet»,
e-mail: bogdan-5@mail.ru,
Bogdan Vasiliy Genrihovich
Bogdan V.G. PhD, associate professor, medical colonel, deputy head of the military medical faculty of EE “Belarusian State Medical University” on educational work and research.
Tolstov D.A. An assistant of the military-field surgery chair of the military medical faculty of EE “Belarusian State Medical University”.